Research-related knowledge, understanding and practice in public mental health: the voices of social workers and occupational therapists.

INTRODUCTION: Previous studies have explored facilitators and barriers to research conducted by allied health professionals in general medical settings. Since the mental health system is acknowledged to be significantly under-funded and more poorly functioning than general medical services, it is unclear whether the published facilitators and barriers also apply to mental health settings. This study sought to explore the research-related knowledge, understanding and practices of allied mental health clinicians based in a large public mental health service. METHODS: A mixed methods study recruited 59 occupational therapists and social workers working in a dedicated metropolitan public mental health service in Melbourne, Australia. Quantitative survey results are reported elsewhere. Semi-structured interviews were conducted with 16 survey responder volunteers. Thematic analysis was conducted on the qualitative survey and interview data. RESULTS: Four main themes were identified: research must connect with clinical practice; fragments of knowledge; research in practice; and research is not part of my professional identity. The third theme, research in practice, comprised four subthemes: no time for research in clinical roles, missing communication, lack of ownership, and what I need to do research. CONCLUSIONS: This study found that research and research-related activities were not considered part of the mental health social workers and occupational therapists' professional identities. Dealing with this issue may be instrumental to the realization of these clinicians' professional peak-body associations' code of practice and to government mandated practice standards. We provided several strategies to encourage both clinicians and services to view research-related activities as an everyday part of clinical roles. This is especially important if we think of allied health evidence-based practice requiring a reasonable level of research-related skills and/or competencies to appraise, practice, evaluate and adapt their evidence-based practice.

The extent of implementation and perceptions of maternity and social care professionals about two interprofessional programs for care for pregnant women: a mixed methods study.

BACKGROUND: In 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children's development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation. METHODS: We conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren's implementation model. RESULTS: The findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives' daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources. CONCLUSIONS: Areas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.

Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study.

BACKGROUND: The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. OBJECTIVE: This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. METHODS: We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. RESULTS: A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. CONCLUSIONS: Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.

How Social Workers Can Be Deployed to Assist with the Ongoing Opioid Crisis.

The opioid epidemic has claimed more than 1 million lives in the United States over the past two decades. The persistent increase in deaths indicates that current strategies intended to decrease the negative consequences of opioid use are inadequate. Harm reduction strategies are designed to promote safer substance usage and reduce overdose mortality rates, yet the implementation of harm reduction programs is inhibited by community- and provider-level stigma against people who use opioids, coupled with limited understanding and insufficient education about harm reduction approaches. Despite ongoing research, engagement in opioid treatment programs remains a challenge, and the opioid crisis continues to disproportionately harm marginalized populations. This article describes how social workers are prepared to play a larger role in opioid use treatment because they are trained with the skill set and values necessary to facilitate access to harm reduction programs, promote engagement in substance use treatment, and create and advocate for interventions to address problematic substance use, especially in high-need communities.

Validation of the psychoactive substance refusal Self-Efficacy Questionnaire (PSRSEQ) in adolescent case-clients of social workers in Hong Kong.

BACKGROUND: Self-efficacy is a key concept in various behavioral theories. Refusal self-efficacy is important in understanding issues related to psychoactive substance use. To facilitate related research, this study translated and validated the Chinese version of the 14-item Psychoactive Substance Refusal Self-efficacy Questionnaire (PSRSEQ) among adolescents. There is a debate about whether such a refusal self-efficacy scale should be unidimensional or multidimensional. METHODS: A survey was conducted among 601 adolescent case-clients of social workers in Hong Kong from July 2021 to June 2022. Various psychometric properties were examined. RESULTS: The confirmatory factor analysis (CFA) supported the original 3-factor structure of the PSRSEQ (emotional relief, opportunistic, and social facilitation refusal self-efficacy), which showed satisfactory psychometric properties (internal consistency, convergent validity in terms of significant negative correlations with the intention of psychoactive substance use in the next year and psychoactive substance use behavior in the past six months, and the absence of floor effect) but ceiling effect was obvious. Notably, unacceptable discriminant validity of one subscale and strong correlations among the three subscales were observed. In another set of analyses using two split-half subsamples, the exploratory factor analysis identified a 1-factor 14-item structure, which was confirmed by CFA and showed satisfactory psychometric properties. CONCLUSIONS: The 1-factor PSRSEQ, instead of the one having a 3-factor structure, was preferred and recommended to assess psychoactive substance refusal self-efficacy among Chinese adolescents. It is warranted to validate the scale in other adolescent and age groups in future studies.

Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies.

OBJECTIVE: At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions. METHODS: A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic. RESULTS: Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients' care options, professionals' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals' moral comfort. Patients' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change. CONCLUSION: This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals' beliefs, repercussions on professionals' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.

mHealth based intervention by social care professionals to support family caregivers to persons with dementia living at home in Sweden (Caregiver Connect): a randomized controlled trial.

BACKGROUND: The majority of persons with dementia in Sweden reside in their own homes with support from family members. Approximately, 12% of persons with dementia have immigrant background. Within the next 20 years, the number of persons with dementia who are non-ethnic Swedes is said to double. Family caregivers with immigrant backgrounds are noted to receive less support in the community than ethnic Swedes and rate their health status lower than ethnic Swedish peers. The Swedish National Board of Health and Welfare have highlighted the importance of follow-up support for family caregivers with immigrant backgrounds as there is a recognized gap in research and available information tailored to meet the needs of this group. PURPOSE OF THE STUDY: The purpose of the study is to test effectiveness of an mHealth based intervention through which community social workers can improve caregiving competence of non-European immigrant family caregivers of people with dementia living at home in Sweden. The overarching aim is to reduce caregiver burden and depressive symptoms, and improve quality of life. METHODS: A randomized controlled trial (RCT) including wait list control group will be performed consisting of an intervention group (A, n = 44) and a wait list control group (B, n = 44), totaling a sample size of 88. On completion of the 10-weeks long intervention in the intervention group, the intervention will be delivered to group B. Effect of the intervention will be analyzed between and within groups over time. The content of the educational component of the intervention is inspired by the iSupport manual developed by the World Health Organization. The contents, in the form of a booklet, aims to equip the family caregivers with structured information on understanding dementia as a condition and its management at home, including self-care guidance designed specifically for family caregivers themselves. DISCUSSION: Similar telephone-delivered intervention studies targeted for family caregivers to persons with dementia are ongoing in Malaysia and will start in India using the same booklet adapted to the local context. These studies will provide evidence on the effectiveness of using digital technologies to deliver support to those who may not be reached or adequately served by the traditional healthcare system. TRIAL REGISTRATION: ISRCTN registry, Registration number ISRCTN64235563.

Challenges perceived by social workers to prevent FGM/C in Bavaria: a prospective, cross-sectional survey.

BACKGROUND: Worldwide, at least 230 million girls and women are affected by female genital mutilation/ cutting (FGM/C). FGM/C violates human rights and can cause irreparable harm and even lead to death. In 2022, more than 100,000 survivors of FGM/C lived in Germany, and more than 17,000 girls were considered at risk. Due to the increasing number, there is a need to improve the skills of professionals not only to treat FGM/C but also to prevent it, aiming to maintain or improve women's physical and mental health. However, previous studies mostly focused on health care providers, even though other professionals such as social workers, play an important role in the provision of sexual and reproductive health (SRH) care and are often the first point of contact. Therefore, the study's main objective was to understand challenges perceived by social workers in pregnancy counselling centres in the provision of good quality of SRH care for girls and women suffering from or endangered by FGM/C. METHODS: A quantitative self-administered cross-sectional online survey was sent by e-mail in 2021 to all pregnancy counselling centers in the German federal state of Bavaria. RESULTS: Among the 141 participants, 82% reported no or insufficient FGM/C knowledge and barriers to provide the best quality of care. The main findings were language obstacles (82.7%), perceived client's fear or shame (67.9%) and cultural difficulties (45.7%). Furthermore, participants also reported a lack of competence on the professional side (29.6%). Importantly, most participants (129 of 141; 92%) expressed interest in training. CONCLUSION: Providing comprehensive good quality sexual and reproductive health care to women and girls affected from or endangered by FGM/C is challenging. The study revealed the importance of strengthening the skills of social workers and suggested the following strategies: (1) enhancing FGM/C knowledge and skills (including specialized competences e.g., in mental health) by improving training and information material for the target group, (2) improving referral pathways and addressing deficits in the existing care system (e.g. with health or legal institutions), and (3) developing trusting relationships with cultural (or traditional) mediators to build strong community networks.

Discharge process for patients experiencing homelessness in the emergency department: A thematic qualitative study.

People experiencing homelessness are more likely to utilize emergency departments than their non-homeless counterparts. However, obtaining a bed in a homeless shelter for patients can be complex. To better understand the challenges of finding a safe discharge plan for homeless patients in the emergency department, our team conducted interviews with emergency department social workers and homeless shelter case managers in the Boston area. We identified and mapped the stages in the processes performed by both parties, identifying challenges with successful placement into a shelter. Furthermore, we assembled a data dictionary of key factors considered when assessing a patient's fit for a homeless shelter. By identifying bottlenecks and areas of opportunity, this study serves as a first step in enabling homeless individuals to receive the post-discharge assistance they require.

Online sexual abuse of children with disabilities: Analyzing reports of social workers' case files in Israel.

BACKGROUND: Online child sexual abuse (OCSA) is a growing social concern. However, its manifestations among children with disabilities (CWDs), who face an increased risk of sexual abuse, remain largely unexamined. OBJECTIVE: This study aims to fill this gap by examining professionals' perspectives of the OCSA of CWDs through their work at the 105 Hotline, an Israeli national call center that accepts queries and reports of the cyber victimization of minors. METHODS: A mixed methods research design was employed. A quantitative analysis was performed on 114 case files involving the OCSA of CWDs, followed by a thematic content analysis of 23 follow-up files by social workers. RESULTS: The quantitative findings revealed various characteristics of the survivors, their families, and OCSA. The qualitative analysis revealed that professionals indicate multiple interrelated risk factors for the OCSA of CWDs on three levels: child, related to the child's characteristics and disability traits; family, referring to familial complexities, parenting challenges, and socio-economic position; and relational, referring to the online abusive relationships between the perpetrator and the survivor. Furthermore, the online platform comprised characteristics that enhanced the risk of OCSA of CWDs. CONCLUSIONS: The understanding that the OCSA of CWDs as a compounded risk that encompasses personal and environmental risk dimensions is necessary and should guide all professionals' decisions and actions. There is also an urgent need for governmental and community efforts to develop measures, policies, and support systems to reduce OCSA risks for CWDs. Moreover, knowledge and interventions should be developed for professionals and parents of CWDs to improve the identification and response to this overlooked phenomenon.

Silent suffering: The hidden challenges confronting unaccompanied refugee children through the eyes of social workers.

BACKGROUND: Unaccompanied refugee children are one of the most vulnerable categories within the refugee population. They face inexhaustible risks from the start of their journey until its conclusion; being exposed to various forms of violence, assault, and exploitation during the transit phase. OBJECTIVE: This study was aimed to discern the challenges faced by unaccompanied refugee children in Jordan, as perceived by social workers. Additionally, to uncover the role of the social work profession in helping these children in confronting and alleviating these challenges. PARTICIPANTS AND SETTING: Ten social workers working with unaccompanied refugee children in the International Medical Corps in Jordan were selected to take part in the study. METHODS: The study adopted a qualitative research approach to achieve its aims. Semi-structured interviews served as the primary method for data collection. Data analysis used inductive thematic analysis, and ethical considerations were consistently observed throughout the study process. RESULTS: The study revealed significant social challenges, including strained alternative familial relationships and difficulties in social integration. Psychological struggles were clear in enduring loss, separation, and suicidal thoughts. Economic hardships manifested in meeting basic needs and child labor. School dropouts appeared as a prominent educational issue. Social workers are primarily engaged in case management, providing psychosocial support, and easing referrals. CONCLUSIONS: Adverse living conditions profoundly affect children, affecting their psychological, physical, and social development. This leads to the emergence of deep psychological traits such as sadness, hostility, anxiety, and behavioral disintegration. Consequently, many children experience social disconnection and struggle to adapt to their environment effectively.

Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio.

BACKGROUND: Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS: Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS: Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS: Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.

Priorities for enhancing nurses' and social workers' competence and confidence in helping families support dependent children through parental death. A classic-Delphi survey.

BACKGROUND: Annually, approximately five per cent of dependent children - aged under eighteen years - in the United Kingdom (UK), experience parental death. Nurses and social workers caring for parents with life-limiting illnesses, including cancer, help families support their children. However, these professionals have been found to lack confidence and competence in fulfilling this role. METHODS: We conducted three rounds of a classic-Delphi survey to identify and measure a panel of topic experts' consensus on the priorities and issues for nurses and social workers when supporting families and children through parental death. The Delphi survey was conducted with a panel of UK topic experts (n=43) including lead health and social care professionals (n=30), parents bereaved of a partner whilst parenting dependent children (n=6), academics (n=4) and bereaved young adults (n=3). RESULTS: Ninety per cent (n=18/20) of the issues for nurses and social workers and all (7/7) of the priorities rated and ordered in the survey achieved consensus. Key priorities were 1) training in opening conversations with families about dependent children, 2) training and support for nurses and social workers to manage their own and others' emotions arising from conversations with parents about children's needs regarding parental death, and 3) increasing nurses' and social workers' knowledge of sources of information to support families before the death of a parent. CONCLUSION: We identified priorities for UK nurses and social workers. Further research is needed to identify which of these nurses and social workers would benefit most from support, and how any resultant interventions could enhance confidence and competence in helping families to support children through parental death.

Impact of a Mental Health Screening Process in a Pediatric Emergency Department.

OBJECTIVE: The aim of this study was to describe how specific mental health-trained social workers can assist in the evaluations and follow-up of patients presenting with mental health concerns in the pediatric emergency department (ED). METHODS: Work was performed at a quaternary children's hospital ED with 95,000 annual ED visits across 2 locations. Patients requiring mental health services identified based on presenting complaint or from universal suicide screen were included. Emergency department team first evaluates the patients for medical screening and then consults a team of social workers specialized in acute mental health screening (AMHS). The team evaluates and provides recommendation for disposition and assists in plan completion. For patients not admitted, AMHS team makes 24- and 48-hour calls to ensure safety. We collected and analyzed the data on all eligible patients from September 2015 through June 2019 for (1) demographic information, (2) trends in number of consults to AMHS, (3) disposition plans and trends by year, and (4) frequency of follow-up phone calls. RESULTS: A total of 5950 patient visits were reviewed, for 4454 distinct patients. Most patients were 12 to 17 years of age, female, and White, with Medicaid being the predominant insurance. The most common chief complaint was suicidal ideation/plan/attempt. Self-referrals were the majority of assessments, and 59% of patients were already receiving mental health services. Median team response time was 19 minutes. There was an upward trend in consults. Psychiatric hospitalization was the most common disposition; more than 95% of the other visits had timely follow-up phone calls. CONCLUSION: Despite an increasing number of patients presenting to the ED with mental health crisis, safe and efficient management is possible with ED staff-social worker partnership. This approach can ensure that eligible patients receive consistent and evidence-based evaluations and can allow ED clinicians to respond to medical emergencies that require their attention.

Outcomes of Aggression and Victimization in Social Welfare Services.

This study examined two significant phenomena that occur in the workplace, aggression and victimization, and their outcomes. The study's participants were 470 social workers employed by social welfare services in Israel. The examined outcomes were stress symptoms, emotional exhumation, and decline in quality of service climate. The associations between aggression, victimization, and their outcomes were examined via linear regression during Stata 14. The study found that the similar outcomes of aggression and victimization are stress symptoms and emotional exhaustion, while service climate (decline in quality) was associated only with victimization. While most studies have examined mainly victimization outcomes, the current study examined both aggression and victimization outcomes. This article sheds light on the similarities and the difference of outcomes between aggression and victimization and explicates the phenomena of workplace aggression from two important and complementary aspects of aggression and victimization. It is important to refer to either aggression or victimization while considering workplace aggression. Authors recommend for further studies to continue to investigate both aggression and victimization while researching workplace aggression outcomes.

At the Forefront: Social Workers' Role in Psilocybin Treatment for Depression and Substance Misuse.

This article underscores the critical role of social workers in harnessing the potential therapeutic benefits of psilocybin for treating major depressive disorder (MDD) and substance use disorder (SUD). Contemporary treatments for MDD often have side effects, and the success rate for SUD treatments remains low. The pervasiveness of MDD, combined with the challenges in treating SUD, highlights a need for innovative treatments. This article provides an overview of the resurgence of literature over the past two decades that illuminates the therapeutic promise of psilocybin for mental health treatment; clinical trials elucidate the efficacy of psilocybin-assisted therapy in mitigating MDD and demonstrate great promise in reducing SUD symptoms. The long-lasting posttreatment effect emphasizes its potential as a novel treatment modality. Furthermore, psilocybin's recognition as a "breakthrough therapy" by the U.S. Food and Drug Administration (FDA) and the accelerating pace of psychedelic reform bills indicate growing acceptance and interest in its therapeutic capacities. Psilocybin-assisted therapy emerges as a potent treatment option, showcasing remarkable effectiveness even after a single dose. Recommendations and pathways for social workers to be involved in psilocybin-assisted therapy investigation, advocacy, and implementation are provided.

Diagnoses of common mental disorders among social workers in Sweden: A register-based cohort study.

BACKGROUND: Little is known about common mental disorders (CMD) diagnoses among social workers, i.e., depression, anxiety, or stress-related disorders. This study aims to examine the risk of CMD among social workers in comparison to other workers and to further investigate differences between men and women and specific occupational titles. METHODS: This register-based cohort study consists of 3,034,304 persons, of which 26,610 were social workers (0.9 % of all workers), aged 30-64 years, living in Sweden in 2015. The risk of diagnosed CMDs was followed up until 2020. Cox regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI), adjusting for sex, birth country, education, and birth year. RESULTS: The participants were followed up by a total of 16,833,742.9 person-years, with an average follow-up of 5.5 years. Social workers, compared to other workers, were at a higher risk of CMD (HR 1.3, 95 % CI 1.2-1.4) after adjustment. The HR was equal, 1.3, for depression (95 % CI 1.2-1.5) and anxiety or stress-related disorder (95 % CI 1.2-1.4). The association between social work and CMD was stronger among men (HR 1.7, 95 % CI 1.6-1.9) compared to women (HR 1.2, 95 % CI 1.1-1.3). Further, men working as assistance analysts had the highest risk among the occupational categories (HR 2.2, 95 % CI 1.2-3.9). LIMITATIONS: CMD diagnoses only included cases treated in secondary care. CONCLUSIONS: Social workers, especially male social workers, had a higher risk of CMD. This deserves attention for future research and interventions aimed at improving the mental health of social workers.

Social Workers' Perceptions Regarding Legal Intervention for Older Adults without Significant Cognitive Decline Who Are Abused by Their Adult Child.

Social workers aiding older adults facing abuse from their adult child confront an ethical dilemma: whether to honor autonomy or prevent harm. The study explores how social workers perceive legal intervention against the older adult's will. Twenty-one aging-specialized social workers took part in semi-structured interviews using a vignette. The analysis was conducted inductively, guided by content analysis principles. Two main themes emerged, focusing on the disadvantages and benefits of legal intervention. The findings underscore that combining teleological and deontological considerations could form a foundation for developing decision-making tools to aid social workers in navigating this dilemma effectively.